Careful medication and lifestyle management is key for patients on an anticoagulation regime

Anticoagulants are medications used to treat a variety of medical issues in patients who are prone to blood clots. Anticoagulants work to reduce the risk for clotting; they are available orally or as an injectable solution. The most commonly prescribed anticoagulant in the United States is warfarin (Coumadin®). While both forms of medication work well to prevent serious complications, including stroke, heart attack and pulmonary embolism, the medications themselves can cause serious problems if they are not carefully monitored by medical professionals.

The anticoagulation management service at Mercy Regional Medical Center helps patients manage their warfarin medication dosage through routine blood testing and counseling. Because many factors, including diet or other medications, can interfere with the effectiveness of anticoagulants, the anticoagulation management service at Mercy Regional Medical Center has a focused approach on coordinating care.

"The most important thing we monitor is the potency of the anticoagulant medication," explains Sarah Suffel, lead clinical pharmacist at the anticoagulation service clinic at Mercy, "when the dose is incorrect, the medication may be too strong, leaving patients prone to serious complications such as bleeding. But when the dose is too low, the risk for clotting is a concern."

So, what takes place at a typical anticoagulation management appointment? "The appointments are usually brief," says Sarah, "We obtain a small blood sample from a finger stick, and read the results on the spot. Based on the results, we may adjust the medication dosage if needed. We always discuss the patient's diet and any other medications he or she may be taking, and any other changes that may impact the anticoagulation therapy."

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Why is diet such an important factor when managing an anticoagulation regime? "Vitamin K is one factor in the body's natural means for clotting. Normally, the clotting response is appropriate to stress/injury - for example, when you form a scab over a scrape or cut - vitamin K is crucial for that reaction," says Sarah. Warfarin works by inhibiting the body's ability to synthesize certain proteins with vitamin K.

"It isn't often that a medical professional will discourage a patient from consuming leafy green vegetables!" says Sarah. "Consistency is key - if your vitamin K intake is stable, then we can adjust the medication accordingly. But if you suddenly introduce or eliminate foods, particularly vegetables, you may throw your anticoagulation regime off course."

Because of the serious nature of the conditions that anticoagulants treat - including blood clots in the legs, arms, and/or lungs, clots that arise from irregular heart rhythms, circulation problems (peripheral vascular disease, severe heart failure, cardiomyopathy, or coronary heart disease), or strokes - the risks of anticoagulation therapy are worth it - but the medication needs continuous supervision.

"But proper management is crucial," cautions Sarah, "Our goal with every patient is to educate them and work closely with their primary care physician, cardiologist, or neurologist to monitor and maintain therapeutic medication levels. An individualized program is key."

A physician referral is required for participation in the clinic. To make an appointment with the anticoagulation management service, call (440) 960-3420.